If you have a basal cell carcinoma, it may be that you need a two stage procedure; the first being the excision of the tumour, and the second about 5-7 days later, once the biopsy results are back, being the reconstruction of the excision site. This can involve a total reconstruction of eyelid, a skin graft or a skin flap.
However, this information page is looking at a more simple biopsy of eyelid lesion, in which case the surgery would be done in one sitting and is most likely to be carried out under local anaesthetic, so the pre-operative instructions are not onerous.
The procedure is likely to be around 25 minutes long. You will need a driver to take you home after surgery. Please arrange someone to be at home with you that evening/night in case you need any help.
On the day of surgery you should avoid wearing moisturiser or make-up around the lesion/your eye area. You may eat and drink as usual, although you should avoid drinking alcohol.
Assuming you notify Mr McMullan of all medication at your initial consultation, unless told otherwise, you may continue to use other medication up to and following surgery. Again, unless told otherwise, please stop taking any medication that thins your blood, eg Aspirin /Ibuprofen etc, prior to surgery. If there is any doubt about whether these drugs are safe to omit, please contact your GP or cardiologist.
It is important that Mr McMullan is made aware of any vitamins and herbal supplements you are taking. Although these can offer benefits they can also cause adverse effects in surgical procedures. In particular, please avoid ginseng, garlic, ginkgo biloba, vitamin A, C & E pills for 10 days prior to surgery.
Some people find taking Arnica (available at chemists/wholefood shops) in the ten day lead up to surgery can help reduce bruising.
You should avoid alcohol for the three days leading up to, and for three days after, surgery as this increases the risks of bleeding and poor wound healing.
You will be taken into the operating theatre and made comfortable. If the lesion is on the eyelid, drops will be placed in the eyes to numb them and so please avoid contact lens wear. An anaesthetic injection will be given and Iodine will then be used to clean the operating site and surgical drapes will be used.
The anaesthetic stings for 5-10 seconds and may cause bruising. You may notice some numbness for a few hours which will wear off.
The lesion/s will be removed and, if the lesion was on or near the eyelid, an eye patch may be applied which helps reduce the bruising and swelling.
You may remove the pad the next day. There may be some blood staining on the pad when you remove it – this is normal and nothing to worry about.
After the surgery it is important to keep your head above your heart for at least five days to prevent undue bruising or oozing from the wound. Please keep your head raised on pillows when lying down.
Antibiotic ointment is usually applied to the wound three times a day for three weeks.
You shouldn’t have any pain but if you do this can be alleviated by, for example, paracetemol.
Your biopsy site must be kept clean to avoid infection. It may be necessary to gently bathe it using cool, boiled water and cotton wool or gauze. Remember to wash your hands first. Please do not rub the site.
If sutures are placed then it will be clearly explained whether these are removable sutures in which case they will need to be removed at 5 days or if they are dissolvable sutures then they should find their way out over the week or two after surgery.
Results of the biopsy (histopathological analysis) will be communicated as soon as they are made available and follow up will be determined on the day of your surgery, taking into account the nature of the surgery.
Your vision may be blurry for at least a day or two and as such its best not to drive for at least two days although obviously this depends on other factors such as whether one or both eyes are affected and the vision in the non-operated Eye etcYou should avoid swimming for at least three weeks and be careful to shield the operative site from sunburn.
Please avoid driving for around three days, or longer if the bruising is still considerable and is affecting your vision. You may need to take three or four days off work.
Depending on the site of the surgery, there may be a small degree of scarring or eyelash loss. The standard risks for eyelid surgery apply namely: bruising and swelling (likely), infection (unlikely), bleeding (unlikely), scarring (unlikely but not impossible), recurrence of the lesion and further treatment or surgery, depending on the nature of the lesion and the healing process and laboratory results.